Policy paths and perspectives during the pandemic
In February 2020, Manoj Mohanan walked with Duke alumnus and health changemaker Paul Farmer across the campus from the Sanford Building to Page Auditorium. The venue was packed for the momentous conversation between two global health experts. Just a few weeks later, a world health issue, COVID-19, locked the world down.
Mohanan leaped into the ensuing health crisis. He had already led and collaborated on large-scale research projects studying health policy questions in countries including India, Kenya and Rwanda. His work has identified crucial gaps in the implementation of health care delivery in India, and his work continues today with global organizations to understand how to implement change. As the pandemic unfolded, he explored the consequences of its impact on mental health outcomes and the resilience of future households, receiving a pilot grant to track its long-term effects. The pilot led to a $3.3M grant from the NIH. For this research in global health and on COVID-19 seroprevalence studies in India, he was recognized as one of the 100 Most Influential Academics in Government.
Mohanan has been joined by other Sanford researchers, students and alumni tackling this unprecedented global pandemic.
In March 2020, Sanford alumni Ryan Smith MPP’14 and Mariel Beasley MPP’13 recognized the need for more research on best practices, current data and evidence-based solutions for the struggling residents of Durham city and county as they faced the rapid spread of COVID-19.
Smith reached out to Sanford Dean Judith Kelley, who responded. As their summer internships disappeared, there was an opportunity for Sanford students to step in and help with a real-time crisis.
Working with the Durham Recovery & Renewal Task Force, 20 volunteers worked as research assistants – 12 MPP students and recent graduates, one undergraduate public policy major, four students from North Carolina Central University and one from UNC Chapel Hill.
Helping to consult and advise the mayor and county on local policy decisions that affected the lives of residents, these research assistants acted as a “rapid response think tank,” providing memos of best practices and emerging data on responses to COVID-19 to the task force and roundtable members. Helping to consult and advise the mayor and the county commissioner on local policy decisions that affected the lives of residents, these research assistants acted as a “rapid response think tank,” providing memos of best practices and emerging data on responses to COVID-19 to the task force and roundtable members.
Mary Grace Stoneking MPP’21 interned with the Durham City Manager’s office that summer and reflected: “This has taken every skill Sanford teaches in our classes and applied them in a real situation. I didn’t expect to see how a memo from an MPP student can change things in real-time.”
At the state level, Stephanie McGarrah MPP ’00 was appointed to lead the North Carolina Pandemic Recovery Office just three weeks after the North Carolina General Assembly passed a bill establishing the office.
“People love to use the analogy that you're trying to build a plane while you're flying it. And that's sort of what it felt like,” McGarrah said.
McGarrah found herself falling back on the skills she learned while at Sanford. By late 2022, the North Carolina Pandemic Recovery Office had coordinated federal funds received by state agencies and local governments and proper reporting and accounting of all funds, including the $3.6 billion from the Cares Act.
Sanford researchers and alumni were active on every front – locally to globally – to advance health policy throughout the pandemic.
Sanford’s health policy research extended into other health issues even as the pandemic raged: mental health care, health insurance, caregiving for veterans, and more.
Kate Whetten and partners helped provide mental health care to orphans in multiple countries. Researchers trained laypeople as counselors to deliver treatment in both urban and rural communities in Kenya and Tanzania. They evaluated the progress of children and their guardians through sessions of trauma-focused cognitive behavioral therapy. The research demonstrated that lower-cost, scalable mental health solutions are possible for a part of the world where mental health resources are scarce.
Kate Bundorf published a study examining how web-based tools can help people choose insurance plans. The study focused on Medicare Part D, publicly subsidized prescription drug insurance for older adults. The researchers found that providing algorithmic expert recommendation helped people choose among plans. People who used the tool were more likely to switch plans, saved money and generally were more satisfied with the choice process.
By 2028, one in five North Carolinians will be 65 and older. To address the needs of this increasing population, the North Carolina Institute of Medicine (NCIOM) unveiled a set of 12 actionable recommendations aimed at enhancing social connections, falls prevention, food and nutrition security and mobility for the aging population in North Carolina. These recommendations, part of the report "A Place to Thrive: Creating Opportunities to Age Well in North Carolina," were formulated by the Task Force on Healthy Aging, which includes Sanford’s Nathan Boucher. Boucher was appointed to and served on the NC Institute of Medicine Health Aging Task Force during 2022-2023.
Examples of impact in health policy
Health Policy Leader
Sonia Sekhar MPP’20 served as the 2022 graduation speaker for the Sanford graduate ceremony. Sonia Sekhar currently serves as Deputy Director of the NY State of Health, New York’s official health plan marketplace. She has experience working on health policy issues at the federal and state levels including at the Center for American Progress, the White House Office of Health Reform and Colorado’s Health Insurance Marketplace.
Winston Fellowship Winner
Ari Panzer MPP’23 was awarded the David A. Winston Health Policy Fellowship for 2023-2024, one of only two awardees for this fellowship.
Food Aid & Malnutrition
Niisoja Torto PPS ‘20 accomplished two feats: completing an honors thesis and achieving publication in the BMJ Nutrition, Prevention, and Health Journal. Torto’s thesis explored the role of food aid and assistance in addressing the double burden of malnutrition in Ghana. The double burden problem presents a paradox – the coexistence of undernutrition with obesity in low and middle-income countries. Torto explored the problem to better understand the role of the United Nations World Food Programme (WFP) activities in targeting food access, food systems and socioeconomic disadvantage determinants of the double burden.
Kushal Kadakia PPS’19 won a Joel Fleishman Distinguished Scholar Award in part for teamwork on the Bass Connections Medicaid Reform Advisory Team that produced recommendations for the NC Department of Health and Human Services.
Advancing American Health
Graduation speaker Meril Pothen MPP’20 is working to make health care more affordable, accessible and equitable for all Americans. As a Presidential Management Fellow in 2021, Pothen began her fellowship at the U.S. Department of Health and Human Services. While at the Centers for Medicare and Medicaid Services within HHS, she helped lead the policy and operational implementation of the No Surprises Act, a bipartisan law that protects patients from unexpected out-of-network medical bills.
Sarah Cross PhD’21 had her health policy research on end-of-life at home picked up by the Associated Press and Reuters on Dec. 11, 2019. By noon the following day, her research was in 400 media outlets, including The New York Times.
National Academy of Medicine
Peter Ubel was honored by the National Academy of Medicine among 100 new members elected to the prestigious National Academy of Medicine in 2020. Ubel, the Madge and Dennis T. McLawhorn University Professor, was selected for his research on the psychology of health care decision-making, revealing the unconscious and irrational forces that influence choices made by patients and physicians.
Podcasting Food Perspectives
Led by Norbert Wilson, the World Food Policy Center focuses on exploring policy, so all people have access to nutritious and affordable food for a sustainable and resilient food system. The center has a widely distributed podcast: The Leading Voices in Food, offering wide-ranging perspectives and knowledge from researchers, community leaders, policymakers, farmers and more.
Helping Disadvantaged Populations
Named in his honor, the Society for Epidemiologic Research (SER) announced the Sherman A. James Diverse and Inclusive Epidemiology Award to recognize research, teaching or service by an individual that expands the scope of the field to under-represented or disadvantaged populations or researchers and that has facilitated greater diversity and inclusiveness.
New Health Policy Certificate
As of the Fall 2022 semester, Duke undergraduates have the opportunity to earn a new Duke Undergraduate Health Policy Certificate. The Duke-Margolis Center for Health Policy and the Sanford School of Public Policy educate students jointly in evidence-based health policy analysis, development, and implementation so they are prepared to address complex challenges in health and health care at local, state, national and global levels.
Through a federally funded research study, Nathan Boucher demonstrated a program using community health workers to support caregivers of veterans. This adds to his federally-funded research studies reducing homelessness among veterans and improving safety policies across the nation’s 171 Veterans Affairs Medical Centers as well as disaster preparedness research informing veterans programs implemented by the Rosalynn Carter Institute for Family Caregiving (Americus, Ga).
Remembering Paul Farmer
As Sanford pushes on in the quest to create a better world, our school honors the legacy of our friend Paul Farmer, who passed away in February 2022.
"On behalf of the Sanford community, we send our condolences to the family, friends and colleagues of Duke alumnus Paul Farmer. His lifelong work in global health and the partnerships he created have made a tremendous difference to people worldwide. We were honored to call him our friend."
– Dean Judith Kelley